Geriatrics & gerontology international
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Geriatr Gerontol Int · Apr 2017
Comparative StudyComparison of three scorıng systems for risk stratifıcation in elderly patıents wıth acute upper gastrointestinal bleedıng.
Acute gastrointestinal bleeding is a potentially life-threatening condition that requires rapid assessment and dynamic management. Several scoring systems are used to predict mortality and rebleeding in such cases. The aim of the present study was to compare three scoring systems for predicting short-term mortality, rebleeding, duration of hospitalization and the need for blood transfusion in elderly patients with upper gastrointestinal bleeding. ⋯ In elderly patients with upper gastrointestinal bleeding, the Rockall score is clinically more useful for predicting mortality and rebleeding than the Glasgow-Blatchford and AIMS65 scores; however, for predicting duration of hospitalization and the need for blood transfusion, the Glasgow-Blatchford score is superior to the Rockall and AIMS65 scores. Geriatr Gerontol Int 2017; 17: 575-583.
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Geriatr Gerontol Int · Apr 2017
Predictive factors for dementia and cognitive impairment among residents living in the veterans' retirement communities in Taiwan: Implications for cognitive health promotion activities.
To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five-item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline. ⋯ Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans' retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7-13.
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Geriatr Gerontol Int · Apr 2017
Comparative StudyPredictors of non-pharmacological intervention effect on cognitive function and behavioral and psychological symptoms of older people with dementia.
Our previous work showed that non-pharmacological interventions could effectively reduce the severity of behavioral and psychological symptoms of dementia (BPSD), while the factors influencing the effect of intervention were less explored. Therefore, the main purpose of the present study was to investigate the predictors of the non-pharmacological intervention effect for old veterans with dementia and BPSD. ⋯ Our findings show that non-pharmacological intervention programs have a significant effect on reducing overall NPI score, NPI caregiver burden score and NPI subdomains - psychotic, affective and behavior syndrome - in old veterans with dementia. In addition, participants with lower cognitive performance, more severe BPSD and depressive symptoms at baseline were more likely to gain benefit from the intervention, whereas antipsychotic use and hearing impairment were negative predictors of improvement of cognition and BPSD, respectively. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 28-35.
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Geriatr Gerontol Int · Apr 2017
Comparative StudyImpact of living arrangements on clinical outcomes among older patients with dementia or cognitive impairment admitted to the geriatric evaluation and management unit in Taiwan.
To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. ⋯ Institutional care was associated with lower 6-month mortality risk for patients with dementia or cognitive impairment after discharge from the GEMU, but this group was more likely to experience functional decline. Further prospective study is required to clarify the clinical impact of living arrangements on long-term outcomes when people with dementia or cognitive impairment are admitted to acute hospitals. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 44-49.
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Geriatr Gerontol Int · Apr 2017
Reduction in the numbers of drugs administered to elderly in-patients with polypharmacy by a multidisciplinary review of medication using electronic medical records.
Polypharmacy is a major problem for elderly patients in developed countries. We investigated whether a multidisciplinary medication review using electronic medical records could reduce the number of drugs administered to elderly patients receiving polypharmacy. ⋯ Multidisciplinary medication review using electronic medical records could significantly reduce the numbers of drugs taken by elderly inpatients receiving polypharmacy, including drugs associated with falls, in both fallers and non-fallers Geriatr Gerontol Int 2017; 17: 653-658.